Factors associated to adherence to blood glucose self-monitoring in patients with diabetes treated with insulin. The dapa study

Abstract

ObjectiveTo assess adherence to self-monitoring of blood glucose and the main factors associated with it, particularly those related to self-perception of glycemia, in patients with diabetes on insulin therapy. Patients and methodsAn epidemiological, observational, prospective, multicenter study conducted in standard clinical practice in primary care, outpatient centers, and hospitals from different Spanish regions. Sociodemographic, clinical and treatment data were collected. Patients were considered adherent to self-monitoring if they performed the minimum number of controls recommended by the Spanish Society of Diabetes (SED). ResultsAdherence was shown in 61.6% of patients. Factors associated to adherence included treatment with less than three insulin injections daily (OR 2.678; 95% CI 2.048–3.5029; p<0.001), presence of peripheral vascular disease (OR 1.529; 95% CI 1.077–2.171; p=0.018), alcohol abstinence (OR 1.442; 95% CI 1.118–1.858; p=0.005), and collection of the glucose test strips from the pharmacy (OR 1.275; 95% CI 1.026–1.584; p=0.028). Adequate self-perception of glycemia was found in 21.4% of patients. ConclusionsOur results show a suboptimal adherence to the recommended protocol for blood glucose self-monitoring in patients with diabetes on insulin therapy. Independent variables associated to good adherence were treatment with less than three insulin injections daily, presence of peripheral vascular disease, alcohol abstinence, and collection of glucose test strips from the pharmacy.